7/7/2015
High Cost / High Acuity
Reimbursement Application
Presented by:
Janice Hay and Shana Clay
July 15, 2015
High Cost/High Acuity Funding Available for
Reimbursement-2015
IDEA Funding
= $ 822,303
State Appropriated Funding = $1,500,000
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High Cost/High Acuity Fund
Eligibility for Reimbursement
 Definition: Individual application for an eligible SWD
who:
 is 3-21 years of age;
 has a current IEP;
 lives within the LEA requesting funds or receives
special education and related services within the LEA;
 court-ordered out-of-state placements (first included
in FY12);
 cost is equal to or greater than $33,400* annually (a
decrease from the 2014 criteria of $33,600 annually).
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7/7/2015
High Cost/High Acuity Fund
Other Excluded and Included Categories for Eligibility
 IEP Placed Out of State Students
 Students with disabilities placed out-of-state by the district IEP
team may not be submitted for reimbursement through the High
Cost Expenditure Fund.
 Out of County Placements
 Students placed into a district by another agency (i.e. foster care
and emergency shelters), may be submitted for reimbursement,
but all High Cost/High Acuity criteria requirements must also be
met.
 Reimbursement will not be provided under both high cost/high
acuity and out-of-county funding reimbursement mechanisms.
High Cost/High Acuity Fund
Eligible Expenses
Costs required to provide direct special education and related
services, as identified in the student’s IEP:
 Personnel (teachers, aides, service providers) including
extended school year
 Evaluations recommended by IEP Team and documented on
IEP
 Supplementary classroom materials for specially designed
instruction
 Assistive technology services or devices identified on the
student’s IEP
 Equipment (mats, prone stander)
 Construction (ramp, handicap accessible bathroom)
 Special transportation (must be noted in IEP)
 Educational cost for court ordered out-of-state students
SWD Served in District with Costs that Meet or
Exceed $33,400 Annually
• Pages 1 through 5 of the application must be
completed and submitted.
– (Page 1 and 6 are to be completed for court-ordered OOS students.)
•
•
•
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Documentation must be submitted to verify all amounts submitted for
reimbursement and to support FTE calculations claimed.
A copy of the IEP for the year in which the expenses were incurred is to be
submitted. (Counties may submit only the pages of the IEP that support the
expenses claimed if desired.)
Payroll expenses claimed should be supported by the PAI.510 report for the
period July 1, 2014-June 30, 2015.
Eligible Medicaid Reimbursement will be subtracted from the total amount of
approved expenses submitted for reimbursement but may be used to determine
whether or not a student meets minimum expenditure criteria.
–
(For example, a student with expenses totaling $34,000 but with eligible reimbursement from
Medicaid at $10,000 meets the minimum expenditure criteria. However, the amount eligible
for reimbursement will be calculated at $24,000.
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FTE Calculation Examples
Instructions for calculation of FTE can be found at
http://wvde.state.wv.us/osp/highcostexpenditures.html Click
on Methods for Calculations.
Few examples include:
• Calculate FTE for Teachers
– Caseload OR
– Actual time (minutes) spent with students
• Calculate FTE for therapists (when employed by
the county as a regular employee)
– Use minutes as recorded on the IEP. Schedules do
not always reflect the true IEP required times - may
be more or less but calculation must be based on IEP
required minutes.
FTE Calculation Examples
• Calculate FTE for bus drivers and bus
aides
– Miles per student
OR
– Minutes each student is on bus
PAI.510 Report
• Run report for the specific application period
– July 1-June 30
• Carefully review the extra pay amounts
– Reduce total pay by these amounts when not
attributable to this student—If attributable to student,
list in column 4 for other pay and explain on page 3 of
application.
– Reduce fixed benefits by amount of pay excluded(i.e. Social Security, Medicare, Retirement)
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7/7/2015
Contracted Services
• Contracted services expenses (therapies,
evaluations, etc. when not provided by a full-time
employee of the county)
• Include a copy of the contract which
supports:
•
•
•
•
service to be provided
hourly or daily rate
service date range
Invoices or other documentation that shows
evidence of service provided*
– *billed services should not exceed minutes as
required on IEP
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7/7/2015
Transportation Allowance
• Utilize the Transportation Allowance Final
Comp tables for the 2015 school year to
calculate mileage rate
• Provide WVEIS attendance report of
absences then claim reimbursement only for
days present x miles traveled on bus per day
– Days school in session less absences
• Use per mile rate , NOT fuel cost per gallon
• Specialized transportation must be specified
on IEP in order to receive reimbursement
Transportation Allowance-Example
School was held 180 days and student missed
25 days. Student rides the bus 15 miles per
day. Calculated rate is $1.81 per mile.
155 days x 15 miles x $1.81 = $4,208.25
A table of calculated mileage rates for each county will be
provided on the website with the High Cost/High Acuity
application and other related information.
Other Reimbursement Items
When listing cost of other items, these
must be required by the IEP. Examples
include but are not limited to:
– Assistive technology (touch screen, text reader,
sound field system, etc.)
– Equipment (prone stander, lift device,
specialized desk, etc.)
– Instructional materials (raised line paper,
computer programs, books on CD, etc.)
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Application & Instructions
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Accessible on the WVDE/OSP website
Finances Tab
High Cost Expenditures Link
Web Address:
http://wvde.state.wv.us/osp/highcostexpenditures.html
Common Errors
• Pay Calculations: remember to reduce the pay when other pay
amounts are listed but are not directly attributable to that student.
Also reduce the benefits by the same percentage, particularly
social security and retirement.
• FTE Calculations: remember to use the total number of minutes
for all students as the denominator and the number of minutes
for the high cost student as the numerator when calculating the
FTE of therapists, and not the caseload number.
• Transportation: only count transportation if it is required by the
IEP.
• Contracted Services:
– remember to include a copy of the actual contract as
documentation.
– remember to include paperwork documenting payment, in addition
to the invoices documenting the students served and hours of
service provided.
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7/7/2015
Application for Reimbursement of
Expenses for
Out-of-State Students placed by
the Courts
High Cost/High Acuity Expenditure
Reimbursement-Minimum Expenditure Criteria
OOS students do not meet the minimum expenditure criteria for 2015:
Costs have declined, students have increased, and avg. per pupil amount
varies.
__________________________________
2011-Estimate of OOS cost: $4,400,000
Number of OOS students: 126
Total cost per student: $34,920
____________________________________
2015-Estimate of OOS cost: $3,650,000
Number of OOS students: 134
Total cost per student: $27,238*
*Does not meet minimum expenditure criteria of $33,400
for FY 2015
Application
However, OSP has reserved $250,000 in another funding source for reimbursement to
those that submit applications. The same application will be used. The potential
reimbursement amount is as follows
Tuition withheld from FY15 special education funding per student
Less Average State Aid Per Pupil (2014‐2015 year)
Less Credit from Prior Year Charges Per Student (Applied 2015 year)
Total Expenses Eligible for Reimbursement
$ 16,440
$ 4,220
$ 7,519
$ 4,701
Last year expenses were reimbursed at approximately 46% of amount requested. If reimbursement under high cost/high acuity funding were permitted, reimbursement per student would equal approximately $2,162 per student.
Minimum Reimbursement with $250,000 set aside if applications are submitted for 133 eligible students = $1,879/student. (Applications were received for 85 OOS students last year. If applications submitted remain at that number for this year, the amount of reimbursement could be as high as $2,941 per student.
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7/7/2015
High Cost/High Acuity Expenditure
Reimbursement
Will OOS students be eligible in future years?
Answer depends on certain variables:
• Amount expended in total on OOS students.
• Average per pupil expenditure
• Number of OOS students
In years that OOS students do not qualify, when financial
resources are available, OSP will set aside $250,000 to provide
reimbursement of cost to counties for the court-ordered OOS
students.
Requirements-Court Ordered OOS
• Completed Application – 1 application per
student (Complete only pages 1 and 6);
• WVEIS enrollment screen showing EO code;
• Current IEP (IEP current when student was in
placement 2013-2014);
• Documentation of LEA /DHHR Participation in
IEP Team Meeting for Out-of-State Student;
and
• Postmarked by July 31, 2015
Consideration of Plan Changes for the High
Cost/High Acuity Fund
• In accordance with IDEA regulations
§300.704, the SEA is to annually review,
and amend as necessary, the State plan
for the high cost/high acuity fund.
• This review should occur in consultation
and coordination with representatives from
LEAs.
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7/7/2015
This year’s application deadline for
the 2014-2015 year.
Applications must be Postmarked by:
July 31,2015*
(Please do not email applications)
*Extension of Due Date
• For those in attendance at today’s
meeting, the due date will be extended to:
August 14, 2015
Please make sure you have signed the
attendance roster and have indicated the
county you represent.
Consideration of Plan Changes for the High
Cost/High Acuity Fund
IDEA §300.704 states that the SEA should
annually review, and amend as necessary,
the State plan for the high cost fund.
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7/7/2015
Consideration of Plan Changes for the High
Cost/High Acuity Fund
• Plan was first developed in 2006 and
participation in the annual review has
dwindled during the years.
• Additional input will be solicited and
participation may be requested.
• Plan change to be discussed is to alter the
plan to consider the financial impact of the
high cost student to the county’s budget.
Consideration of Plan Changes for the High
Cost/High Acuity Fund
• Proposed bills to amend WV Code §18-20-5 that
addresses the distribution of the 1.5 million that is
also a part of the high cost/high acuity
plan. Suggested amendments have stated:
– ….boards shall receive disbursements that equalize,
as near as reasonably possible, the budget
percentage for each county board that is consumed
by eligible, but not reimbursed, expenditures for
serving exceptional children with high cost/high acuity
special needs so that no county board’s budget is
affected disproportionately.
Consideration of Plan Changes for the High
Cost/High Acuity Fund
§300.704 IDEA
• (A) Establish, in consultation and coordination with representatives
from LEAs, a definition of a high need child with a disability that, at a
minimum—
• (1) Addresses the financial impact a high need child with a disability
has on the budget of the child’s LEA; and
• (2) Ensures that the cost of the high need child with a disability is
greater than 3 times the average per pupil expenditure (as defined in
section 9101 of the ESEA) in that State;
• (B) Establish eligibility criteria for the participation of an LEA that, at
a minimum, take into account the number and percentage of high
need children with disabilities served by an LEA;
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7/7/2015
Consideration of Plan Changes for the High
Cost/High Acuity Fund
• An email or other form of communication
will be forthcoming that will discuss
possible plan change as well as to solicit
comments from the county and/or
additional recommendations of change to
the plan.
Questions:
Contact:
Janice Hay
jehay@k12.wv.us
(304) 558-2686, ext.53243
Shana Clay
sdclay@k12.wv.us
(304) 558-2696, ext. 53278
Sheila Paitsel
sgpaitsel@k12.wv.us
(304) 558-2696, ext. 53426
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